Children residing in resource-constrained neighborhoods have greater chances of visiting the emergency departments (EDs) for health problems, suggests a new study published in the journal Pediatrics.¹

In this study, researchers from across the United States examined the association between the Child Opportunity Index (COI) scores and frequency of visits to the ED in children aged ≤17 years from January 2018 to December 2019. The Pediatric Health Information Systems database from 49 children’s hospitals was used for this. The COI measures the quality of resources available in the neighborhood, which have an impact on the healthy development of the child in the area where they reside. Low-resource intensity ED visits i.e., visits that did not involve lab testing, imaging, any procedure or hospitalization, the number of ED visits and hospital admission were the outcomes selected for the study.

Analysis of 6,810,864 ED visits by 3,999,880 children revealed that children from neighborhoods with low COI scores visited the ED more often with OR of 1.73 for ≥2 ED visits and 2.22 for ≥3 ED visits. These ED visits were more likely to be low-resource intensity visits. The odds ratio for one such visit was 1.35. It was nearly doubled (OR 1.97) for 2 or more visits, while for 3 or more LRI visits, the OR was 2.4. Children with very low COI scores were also less likely to be hospitalized in comparison to those with very high COI scores with OR of 0.77.

Not just the medical factors, the social (including economic) conditions of day-to-day life also determine the health outcomes. An interplay of all these factors determines optimal health. These health-related social factors are termed the social determinants of health or “the causes of the causes”.

This study has for the first time examined the impact on neighborhood conditions on emergency hospital visits in children. It has shown that children from neighborhoods with lower quality of resources had higher odds of visiting the ED. Identification of neighborhood factors such as poor housing, poor health literacy among parents/caregivers, high pollution levels, more exposure to environmental hazards and limited access to primary healthcare, which affect the utilization of healthcare services by children can help policymakers in better planning of healthcare systems and strengthening efficiency of primary healthcare.

Reference

1. Kaiser SV, et al. Neighborhood child opportunity and emergency department utilization. Pediatrics. 2022 Sep 2:e2021056098. doi: 10.1542/peds.2021-056098